Illinois Statutes Chapter 215. Insurance § 5/356z.71. Coverage for mobile integrated health care services

(a) In this Section:

“Eligible recipient” means an individual who has received hospital emergency department services 3 or more times in a period of 4 consecutive months in the past 12 months or an individual who has been identified by a health care provider as an individual for whom mobile integrated health care services would likely prevent admission or readmission to or would allow discharge from a hospital, behavioral health facility, acute care facility, or nursing facility.

“Mobile integrated health care services” means medically necessary health services provided on-site by emergency medical services personnel, as defined in Section 5 of the Emergency Medical Services (EMS) Systems Act.

“Mobile integrated health care services” includes health assessment, chronic disease monitoring and education, medication compliance, immunizations and vaccinations, laboratory specimen collection, hospital discharge follow-up care, and minor medical procedures as approved by the applicable EMS Medical Director.

“Mobile integrated health care services” does not include nonemergency ambulance transport.

(b) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026, shall provide coverage to an eligible recipient for medically necessary mobile integrated health care services.